Journal of Oral & Facial Pain and Headache最新文献

{"title":"Artificial intelligence-based prognostic modeling in temporomandibular disorders and chronic orofacial pain: a critical conceptual review.","authors":"Mohammad H Al-Harthy","doi":"10.22514/jofph.2026.049","DOIUrl":"10.22514/jofph.2026.049","url":null,"abstract":"<p><p>This conceptual review (ⅰ) analyzes the outcomes predicted, data modalities, modeling approaches, validation strategies, and reporting quality of existing artificial intelligence (AI)-driven prognostic models in temporomandibular disorders (TMD) and chronic orofacial pain (OFP); (ⅱ) identifies enduring methodological and ethical constraints that hinder clinical translation; and (ⅲ) proposes a pragmatic research framework to guide the responsible development of clinically relevant prognostic tools for TMD and OFP. The review covers peer-reviewed and other relevant publications from the previous decade, emphasizing AI or machine-learning (ML) based models for prognosis, outcome prediction, or trajectory modeling in TMD and OFP populations. Established paradigms, including the Transparent Reporting of a multivariable prediction model for individual Prognosis Or Diagnosis plus Artificial Intelligence extension (TRIPOD + AI) and the Prediction model Risk Of Bias Assessment Tool (PROBAST), were used to assess the literature. Methodologies remain highly inconsistent, and current literature lacks the volume and rigor required for clinical translation. Most AI research has concentrated on diagnostic classification rather than prognostic modeling. Small sample sizes, short follow-up, single-center datasets, omission of psychosocial factors, and a general lack of external validation hamper the few prognostic studies that exist. Most model outputs are neither clinically actionable nor suitable for direct use in treatment decisions, limiting their value for clinicians and their potential impact on patient outcomes. Research applying AI to forecast TMD and OFP remains in its early stages. Without a prognosis-first research design, longitudinal data integration, inclusion of biopsychosocial predictors, and clinically significant outcome objectives, existing models are unlikely to influence clinical practice. Clear research objectives, reporting criteria, and ethical norms must be established before AI-based prognostic models can be confidently adopted in TMD and OFP clinical practice. Future objectives comprise establishing multicenter longitudinal cohorts, conducting trajectory-based modeling, employing federated learning for external validation, and initiating prospective clinical trials to demonstrate clear clinical benefit.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":"40 4","pages":"32-51"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of gepants in migraine management: a narrative review focusing on atogepant and rimegepant.","authors":"Audrey Gautier, Thomas Gicquel, Marion Mercerolle, Brendan Le Daré","doi":"10.22514/jofph.2026.046","DOIUrl":"10.22514/jofph.2026.046","url":null,"abstract":"<p><p>Gepants, oral antagonists of the calcitonin gene-related peptide (CGRP) receptor, represent a new therapeutic class in migraine management. This review aims to assess the efficacy and safety profile of the two gepants currently available in France: atogepant and rimegepant. A review of the literature was conducted in July 2024 using the PubMed, Cochrane Library, and Web of Science databases. Randomized controlled trials evaluating the efficacy and/or safety of atogepant and rimegepant in adult patients with migraine were included. Sixteen randomized controlled trials were selected (nine evaluating atogepant and seven evaluating rimegepant). In migraine prevention, atogepant significantly reduced the mean number of monthly migraine days (-0.7 to -2.4 days <i>vs.</i> placebo), with an improvement in quality-of-life scores (Migraine-Specific Quality of Life questionnaire-Role Function-Restrictive domain (MSQ-RFR): +9.9 to +10.8 points). Rimegepant, administered every other day, achieved a smaller reduction (-0.8 days/month) but was comparable to that observed with some anti-CGRP monoclonal antibodies. In acute treatment, a single dose of rimegepant 75 mg provided complete pain relief at 2 hours in 31-33% of patients versus 15% with placebo. Adverse events, mainly gastrointestinal (constipation and nausea), were generally mild to moderate, with no signal of hepatic or cardiovascular toxicity. Gepants represent a major therapeutic advance combining clinically meaningful efficacy with a favorable safety profile. Atogepant appears particularly promising for migraine prevention, whereas rimegepant offers an effective and well-tolerated option for acute treatment. Their use in clinical practice remains limited in France due to high cost and restricted reimbursement. Further real-world and long-term studies are needed to better define their place within current migraine management strategies.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":"40 4","pages":"1-8"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biopsychosocial assessment of temporomandibular disorder symptoms across bruxism subtypes in dental students: associations with stress, sleep quality, and insomnia.","authors":"Merve Berika Kadıoğlu, Meyra Durmaz, Mehmet Alp Eriş, Özge Uslu-Akçam","doi":"10.22514/jofph.2026.055","DOIUrl":"10.22514/jofph.2026.055","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to determine the prevalence of self-reported bruxism among dental students and to examine its association with stress, sleep quality, insomnia, and temporomandibular disorder (TMD) symptoms.</p><p><strong>Methods: </strong>A total of 480 dental students participated in the study. Based on self-reported questionnaires (subject-based assessment), participants were classified into four groups: combined bruxism, sleep bruxism, awake bruxism, and non-bruxism. Bruxism-related parameters were assessed using the Fonseca Anamnestic Index (FAI), Perceived Stress Scale-10 (PSS-10), Pittsburgh Sleep Quality Index (PSQI), and Insomnia Severity Index (ISI). Statistical analyses were performed using Pearson's chi-square and Kruskal-Wallis tests to compare group differences, followed by multinomial logistic regression analyses to adjust for confounders. Statistical significance was defined as <i>p</i> < 0.05.</p><p><strong>Results: </strong>The overall prevalence of self-reported bruxism was 73.3% and was significantly higher in women (<i>p</i> = 0.001). The proportions of sleep bruxism, awake bruxism, and combined bruxism were 17.1%, 11.9%, and 44.4%, respectively. In univariate analyses, the combined bruxism group demonstrated significantly greater TMD symptom severity as measured by the FAI (<i>p</i> < 0.001; η² = 0.28). In addition, perceived stress (PSS-10; <i>p</i> < 0.001; η² = 0.04), sleep quality (PSQI; <i>p</i> = 0.008; η² = 0.02), and insomnia severity (ISI; <i>p</i> = 0.006; η² = 0.02) also differed significantly between groups; however, the corresponding effect sizes were small. In multinomial logistic regression analyses, only FAI remained independently associated with bruxism subtypes, whereas stress measures, sleep-related parameters, and demographic variables were not retained as significant predictors after adjustment.</p><p><strong>Conclusions: </strong>Within the limitations of a subject-based assessment, self-reported bruxism was frequently observed among dental students. Although combined bruxism was associated with higher TMD symptoms, stress, and sleep disturbances in univariate analyses, only TMD symptom severity remained independently associated after adjustment. These findings highlight the importance of assessing bruxism subtypes separately in relation to TMD symptom burden.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":"40 4","pages":"130-144"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological burden as the primary determinant of suicidal ideation in patients with temporomandibular disorders.","authors":"Tatiana Sella Tunis, Itzhak Agayev, Aya Pessing-Shabi, Yifat Manor, Waseem Abboud, Shoshana Reiter","doi":"10.22514/jofph.2026.051","DOIUrl":"10.22514/jofph.2026.051","url":null,"abstract":"<p><strong>Background: </strong>Assessing suicidal ideation (SI) in patients with primary temporomandibular disorders (TMD) is crucial for its early identification and intervention. This study aimed to investigate the biopsychosocial factors associated with SI in the overall TMD sample and across subgroups of painful TMD patients.</p><p><strong>Methods: </strong>A total of 441 TMD patients were enrolled. TMD was diagnosed using the diagnostic criteria for TMD, and SI was assessed via item 9 of the Patient Health Questionnaire-9. SI prevalence was compared across painful TMD subgroups, stratified by pain duration, and classified according to the International Association for the Study of Pain (IASP) diagnostic criteria. Sociodemographic, Axis I and II, and pain characteristics were compared between the SI and non-SI groups using the Chi-square and Mann-Whitney tests. Binary logistic regression, incorporating pain persistence and depression, was performed to identify the key factors independently associated with SI.</p><p><strong>Results: </strong>In the overall TMD sample, encompassing both painful and non-painful patients, 8.2% reported SI. Among the painful TMD subgroups, SI prevalence was 5.7% in acute cases and 12.0% in chronic cases by pain duration, rising to 20.9% when chronic pain was defined by IASP criteria (<i>p</i> < 0.001). Patients with SI were more frequently divorced, had higher rates of TMD-attributed headache and myofascial pain with referral, and reported greater perceived pain intensity. They also exhibited markedly elevated depression, anxiety, non-specific physical symptoms, pain catastrophizing, and overall distress (<i>p</i> < 0.001), as well as greater disability (<i>p</i> = 0.004). Pain duration was not independently associated with SI, whereas depression emerged as a significant independent predictor (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>These findings highlight the substantial psychological burden in TMD patients, particularly those with chronic pain, and underscore the critical role of depression in SI. Incorporating routine biopsychosocial assessment and SI screening into TMD clinical practice is, therefore, highly recommended.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":"40 4","pages":"84-96"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis-based pathways for conservative and minimally invasive management of temporomandibular disorders: a scoping review.","authors":"Mohammad Gazali, Alfan Maulana Erdiansyah, Husni Mubarak, Abul Fauzi, Andi Tajrin, Hasanuddin Hasanuddin, Muhammad Ruslin","doi":"10.22514/jofph.2026.034","DOIUrl":"10.22514/jofph.2026.034","url":null,"abstract":"<p><p>Temporomandibular disorders (TMDs) encompass a spectrum of musculoskeletal and joint conditions of the masticatory system that frequently lead to chronic pain, limited function, and reduced quality of life. Although conservative and minimally invasive approaches are recommended as first-line therapies, their comparative efficacy remains unclear.This scoping review mapped evidence from randomized controlled trials (RCTs) published between 2015 and 2025 to identify diagnosis-based effective management pathways for TMDs. A comprehensive literature search was conducted using the Scopus, Embase, Web of Science, and PubMed databases for RCTs published within the last 10 years. Eligible studies included adult patients diagnosed with Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) or Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) categories and compared conservative or minimally invasive treatments reporting pain, function, or psychosocial outcomes. Data were extracted and charted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines, and findings were organized into diagnosis-based intervention pathways reflecting first-line, adjunctive, and escalation therapies. A total of 129 RCTs met the inclusion criteria, revealing a stepwise treatment pathway across the diagnostic subtypes. Education, behavioral therapy, and exercise are the first-line management options that improve pain intensity and mandibular function. Splint therapy and other physical modalities can enhance pain modulation. Minimally invasive interventions for refractory cases provide various long-term benefits. Visual Analog Scale (VAS) and Maximum Mouth Opening (MMO) improvements were the primary outcomes, indicating pain relief and functional recovery as therapeutic endpoints. Overall, the evidence from the past decade supports a diagnosis-driven, stepwise model that emphasizes conservative multimodal care as the cornerstone of TMD management. Minimally invasive procedures should be reserved for persistent pain after optimized non-surgical therapy. Future RCTs should standardize diagnostic and outcome measures to strengthen evidence-based clinical pathways.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":"40 3","pages":"26-51"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying neural oscillation and phase synchronization abnormalities in migraine and their predictive values in transcranial magnetic stimulation.","authors":"Yujun Wang, Yazhen Han, Manli Huang, Zhongming Gao, Lingxiao Wang, Xiaolian Ma, Qing Zhang, Xianwei Che, Bolin Tan, Jiqing He","doi":"10.22514/jofph.2026.041","DOIUrl":"10.22514/jofph.2026.041","url":null,"abstract":"<p><strong>Background: </strong>Migraine is a prevalent neurological disorder that may substantially disrupt daily function. Repetitive transcranial magnetic stimulation (rTMS) has been shown to be a promising treatment for migraine, but its treatment efficacy still needs to be optimised. This study aimed to identify abnormal neural oscillations in patients with migraines and evaluate their predictive value for TMS treatments to obtain insights for the optimisation of rTMS paradigms.</p><p><strong>Methods: </strong>Patients with migraine received a course of rTMS delivered over the left dorsolateral prefrontal cortex (DLPFC). Resting-state electroencephalography (EEG) was assessed at baseline in both patients with migraine and age- and sex-matched healthy controls.</p><p><strong>Results: </strong>Compared with healthy controls, patients with migraine were characterised by a slower peak alpha frequency (PAF). In addition, patients with migraine demonstrated alpha-band hyperconnectivity between parieto-occipital regions and between fronto-occipital areas. More importantly, parieto-occipital connectivity showed predictive value for rTMS analgesic effects in this population.</p><p><strong>Conclusions: </strong>These findings support the potential utility of oscillatory biomarkers for optimising rTMS treatment in patients with migraine.</p><p><strong>Clinical trial registration: </strong>Chinese Clinical Trials Registry (ChiCTR2200060337).</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":"40 3","pages":"118-129"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decoding the lipid-migraine link: a genetic and lipidomic investigation of migraine subtypes.","authors":"Liang Zhang, Hong Li, Xiaocen Jin, Kaiyi Zhong, Lijun Liu, Jing Gao, Aijun Ma, Chunyan Jia","doi":"10.22514/jofph.2026.031","DOIUrl":"10.22514/jofph.2026.031","url":null,"abstract":"<p><strong>Background: </strong>Migraine frequently co-occurs with cardiovascular and metabolic diseases. Observational studies examining the association between conventional lipid profiles and migraine risk have yielded inconsistent results and cannot establish causality. This study aimed to investigate the causal effects of specific lipid species on migraine and its primary subtypes: migraine with aura (MA) and without aura (MO).</p><p><strong>Methods: </strong>Using a Mendelian randomization (MR) methodology, this study analyzed genome-wide association study (GWAS) data from the UK Biobank and FinnGen Consortium. Exposures comprised seven lipids and 179 lipid species while the outcomes were overall migraine and its subtypes. Pleiotropy and heterogeneity were assessed using sensitivity analyses such as MR-Egger, weighted median, and Pleiotropy Residual Sum and Outlier (MR-PRESSO).</p><p><strong>Results: </strong>Genetically predicted higher levels of high-density lipoprotein cholesterol (HDL-C; odds ratio (OR) = 0.88; 95% confidence interval (CI), 0.82-0.93) and apolipoprotein A1 (ApoA1, OR = 0.89; 95% CI, 0.84-0.95) were associated with a reduced risk of migraine. Conversely, higher triglycerides (TG) increased the risk of overall migraine. Lipidomic analysis revealed 15 specific lipid species causally associated with overall migraine. Subtype-specific analyses revealed divergent causal profiles for MO and MA. Seven triacylglycerol (TAG) species were specifically associated with an increased risk of MO, whereas only sphingomyelins (SM) (d36:1) was linked to an increased risk of MA.</p><p><strong>Conclusions: </strong>This study provides robust evidence for a causal relationship between lipid metabolism and migraine, demonstrating that these effects are highly specific to individual lipid molecules and migraine subtypes. These findings enhance our understanding of the lipid-mediated mechanisms in migraine pathogenesis and highlight potential subtype-specific pathways for developing future therapeutic and preventive strategies.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":"40 3","pages":"156-166"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Online validation of DC/TMD Axis II questionnaires for assessing temporomandibular disorders.","authors":"Hande Uzunçıbuk, Maria Maddalena Marrapodi, Aida Meto, Marco Di Blasio, Vincenzo Ronsivalle, Diana Russo, Marco Cicciù, Giuseppe Minervini","doi":"10.22514/jofph.2026.040","DOIUrl":"10.22514/jofph.2026.040","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to evaluate the consistency and dependability of the online and traditional analog versions of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Axis II Evaluation Questionnaires.</p><p><strong>Methods: </strong>In a randomized manner, 100 participants completed the questionnaires in both traditional analog and online formats using Google Forms. Internal consistency was tested using the Cronbach's alpha coefficient, with the criterion being >0.700. Intraclass correlation coefficient (ICC) with 95% confidence interval (CI) was applied for the calculation of the analog-online test agreement levels. The mean differences between the online and analog questionnaires were used to calculate effect sizes (ES).</p><p><strong>Results: </strong>Cronbach's alpha coefficients of all scales exceeded 0.700, suggesting satisfactory internal consistency. The ICC values ranged between 0.950 (95% CI: 0.926-0.966) and 0.999 (95% CI: 0.999-0.999), suggesting strong agreement between formats. All the effect sizes fell within the small to medium range, congruently supporting consistency between methods.</p><p><strong>Conclusions: </strong>The present findings indicate that the online version of the DC/TMD Axis II Evaluation Questionnaires can be a reliable instrument for evaluating symptoms in respect to temporomandibular disorders.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":"40 3","pages":"105-117"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Qualitative validation of TnED©, an electronic instrument capturing pain dimensions in patients with trigeminal neuralgia.","authors":"Amine S Tahiri, Serena A Dodhia, Sneha Chotaliya, Hossein Ansari, George Garibaldi, Robert Lasser, Joanna M Zakrzewska","doi":"10.22514/jofph.2026.038","DOIUrl":"10.22514/jofph.2026.038","url":null,"abstract":"<p><strong>Background: </strong>Trigeminal neuralgia (TN) is a severe episodic facial pain that has a significant impact on mood and activities of daily living. To accurately measure pain in TN, patient diaries need to be specifically developed to capture dimensions of pain in both TN phenotypes (<i>e.g.</i>, purely paroxysmal <i>vs.</i> paroxysms with concomitant continuous pain) and their impact on daily life. There is no validated pain instrument that measures specific symptoms of the pain associated with TN. Therefore, Noema Pharma decided to initiate the development and validation of such an instrument. The purpose of this study was to evaluate the content validity of the items that make up the Trigeminal Neuralgia Electronic Diary (TnED©).</p><p><strong>Methods: </strong>Participants were divided into two groups: those with purely paroxysmal pain and those with paroxysmal and concomitant continuous pain; each group was provided with a data collection instrument (diary) specific to their TN phenotype. Participants completed the instrument daily for 14 days. A qualitative, semi-structured interview was conducted to collect feedback on the instrument.</p><p><strong>Results: </strong>A total of 30 participants were enrolled in 2 English-speaking countries (USA, UK). Nearly all participants stated that the items were clear and easy to understand, relevant, measured all symptoms of the condition, and had a suitable recall period and response options. Some participants suggested additional items to be collected. Most participants regarded pain severity as the most important concept due to its debilitating impact on their lives. Few changes to the instrument were suggested, and the study sponsor decided not to implement any of the proposed changes.</p><p><strong>Conclusions: </strong>Overall, the Trigeminal Neuralgia Electronic Diary was well-received and can be used to measure symptoms of TN in clinical trials or in a clinical setting. Psychometric validation of the TnED© instrument is ongoing.</p><p><strong>Clinical trial registration: </strong>NCT06019338, retrospectively registered.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":"40 3","pages":"83-92"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An exploration of possible future non-pharmacological multidisciplinary treatments to potentiate withdrawal strategy and recovery from medication overuse headache (MOH): a narrative review.","authors":"Marco Balordi, Nicholas Diani, Mattia Sinatra, Daniele Lovattini, Gianluca Rossetto, Antonio Morandi, Angelo Bellinvia, Matteo Castaldo, Alessandro Viganò","doi":"10.22514/jofph.2026.032","DOIUrl":"10.22514/jofph.2026.032","url":null,"abstract":"<p><p>Medication Overuse Headache (MOH) is a secondary headache resulting from the sustained overuse of acute headache medications, and represents a clinical challenge for its complex pathophysiology and high relapse rate. This narrative review examines non-pharmacological strategies for the management of MOH, and explores the potential role of a multidisciplinary approach in improving patient outcomes. The available evidence on patient education, psychotherapy, behavioral interventions, physical therapy, and neuromodulation techniques was reviewed, along with other non-pharmacological approaches, such as dietary modifications, Ayurveda, and acupuncture. These interventions may help in targeting multiple dimensions of MOH pathophysiology, and could be tailored to individual patient needs. Integrating multimodal non-pharmacological interventions with medication withdrawal and, when appropriate, bridging therapies appears promising in improving outcomes and reducing the overall burden of MOH. However, further research is required to identify the optimal combination and duration of multidisciplinary interventions.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":"40 3","pages":"1-13"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}